Individual
CHARLEY ERIN BONNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5656 KELLEY ST, HOUSTON, TX 77026-1967
(713) 566-5100
Mailing address
5656 KELLEY ST, HOUSTON, TX 77026-1967
(713) 566-5100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12928
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
881227
MEDICARE EMPLOYER PTAN - USP
TX
01
—
881228
MEDICARE EMPLOYER PTAN - USA
TX
Enumeration date
08/05/2019
Last updated
03/10/2021
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